Reevaluating the medical model

“Right at the moment that I wake up, I get confronted with a body that is not functioning. It takes me an hour to get my muscles going and even more to do the most basic self-care activities. It is my body that prevents me from participating in society, not society itself.” Those were the words of one of our former course participants, living with a physical disability. I doubt if words like these would make him a good politician. He’d rather proclaim that he would put “equal opportunities for persons with and without disabilities” on the political agenda. He would get the hands together for a speech on “Inclusive development”.

Actually, this participant is not against inclusion. In fact, he’s an activist who is lobbying for inclusion at government level. But he’s a realist as well. He knows from his own, painful experiences that it is not jargon that is going to help him to reach his goals in life. He knows that jargon can be beneficial if expressed at the level of ministries. However, he knows too that jargon is almost meaningless when directed at an individual person living with a disability. This person may be helped more effectively with some relaxation techniques for pain relief. His independence may increase with an appropriate ramp to reach his house in a wheelchair. His participation in meaningful activities may be ensured when his workplace would be adapted. However, do we educate our CBR workforce to effectively respond to these practical needs?

We are not seldom surprised about the ability of CBR workers to juggle with today’s jargon. Inclusion, equal rights, full participation in society – the terms are ‘hot’. But when confronted with a child with Cerebral Palsy who has problems swallowing, or a person with stroke who is unable to cook a meal, the same CBR workers get puzzled. Their knowledge of the professional vocabulary does not compensate for their lack of skills to provide practical support and help solve problems, or the attitude required to really comprehend the person’s needs. We fully support the social and human rights models of thinking and dealing with disability matters. However, we also believe that we should not give up on the medical model either, as a large number of persons with disabilities do have serious medical and practical needs.

Within Enablement we are reorienting our focus of work. For sure we will continue paying attention to the social and human rights models within our courses. We will give the best we can to put inclusive development on the political agenda. In addition, we will utilize the passion and expertise of our associate members from fields like physiotherapy, speech and language therapy, occupational therapy, orthotics and prosthetics to design curricula and deliver practical courses. We know that CBR professionals from various continents cannot wait to receive practical and technical training to be able to provide the best possible services to their clients. We will put the training of technical skills, again, on our agenda.


- Huib Cornielje, 5. June 2013 -